“A child with severe pneumonia cannot feed, causing malnutrition”: exploring health worker and caregiver perspectives and practices for mitigating malnutrition among children with severe pneumonia, a case of Uganda
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Severe pneumonia remains the leading cause of morbidity and mortality among children worldwide. Severe pneumonia causes death during hospitalization, and survivors are prone to malnutrition after discharge from the hospital. The World Health Organization and United Nations International Children’s Fund recommend ‘continued’ feeding following a severe pneumonia illness without specific recommendations on nutritional support. This recommendation could influence health workers’ and caregivers’ nutritional practices. This study aimed to explore the perspectives and practices of health workers and caregivers for mitigating malnutrition among children with severe pneumonia.
Methods
We conducted a cross-sectional qualitative study between June and November 2021 among health workers and caregivers of children hospitalized with severe pneumonia at Mulago National Referral Hospital in Kampala, Uganda. The data were collected via focus group discussions involving 17 caregivers and key informant interviews with 12 health workers and were analyzed via the content-thematic analysis approach. Both manual coding and Atlas Ti software were used to support the analysis.
Results
Health workers and some caregivers were aware that severe pneumonia predisposes children to malnutrition to various degrees, citing reduced appetite, difficulty breathing, persistent vomiting, and increased metabolic demands as pathways. Caregivers increased breastfeeding and utilized nutrient-rich foods to prevent malnutrition, while health workers applied caregiver education and tailored pneumonia management strategies, including following available guidelines and working with nutritionists.
Conclusion
Severe pneumonia is recognized among health workers and some caregivers as a risk factor for malnutrition. However, mitigating strategies are not uniformly practiced by caregivers and could be enhanced by effective health education and sensitization. More specific guidelines could further reinforce the beneficial practices of health workers managing children with severe pneumonia who are not severely malnourished, and improve treatment outcomes.
Severe pneumonia remains the leading cause of morbidity and mortality among children worldwide. Severe pneumonia causes death during hospitalization, and survivors are prone to malnutrition after discharge from the hospital. The World Health Organization and United Nations International Children’s Fund recommend ‘continued’ feeding following a severe pneumonia illness without specific recommendations on nutritional support. This recommendation could influence health workers’ and caregivers’ nutritional practices. This study aimed to explore the perspectives and practices of health workers and caregivers for mitigating malnutrition among children with severe pneumonia.
Methods
We conducted a cross-sectional qualitative study between June and November 2021 among health workers and caregivers of children hospitalized with severe pneumonia at Mulago National Referral Hospital in Kampala, Uganda. The data were collected via focus group discussions involving 17 caregivers and key informant interviews with 12 health workers and were analyzed via the content-thematic analysis approach. Both manual coding and Atlas Ti software were used to support the analysis.
Results
Health workers and some caregivers were aware that severe pneumonia predisposes children to malnutrition to various degrees, citing reduced appetite, difficulty breathing, persistent vomiting, and increased metabolic demands as pathways. Caregivers increased breastfeeding and utilized nutrient-rich foods to prevent malnutrition, while health workers applied caregiver education and tailored pneumonia management strategies, including following available guidelines and working with nutritionists.
Conclusion
Severe pneumonia is recognized among health workers and some caregivers as a risk factor for malnutrition. However, mitigating strategies are not uniformly practiced by caregivers and could be enhanced by effective health education and sensitization. More specific guidelines could further reinforce the beneficial practices of health workers managing children with severe pneumonia who are not severely malnourished, and improve treatment outcomes.
Date Issued
2025-07-02
Date Acceptance
2025-06-05
Citation
BMC Health Services Research, 2025, 25
ISSN
1472-6963
Publisher
BMC
Journal / Book Title
BMC Health Services Research
Volume
25
Copyright Statement
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40604971
PII: 10.1186/s12913-025-13014-y
Subjects
Caregivers
Health workers
Malnutrition
Pneumonia
Qualitative
Uganda
Humans
Uganda
Pneumonia
Caregivers
Cross-Sectional Studies
Female
Health Personnel
Male
Qualitative Research
Focus Groups
Child, Preschool
Infant
Adult
Child Nutrition Disorders
Health Knowledge, Attitudes, Practice
Malnutrition
Publication Status
Published
Coverage Spatial
England
Article Number
896
Date Publish Online
2025-07-02